• Development and Usability Testing of a Facebook-based Obesity Prevention Program for Korean American Adolescents

      Park, Bu Kyung; Nahm, Eun-Shim (2014)
      Background: Adolescent obesity rates have quadrupled in the past three decades in the United States. Although Korean American (KA) adolescents have had lower obesity rates than the national average, acculturation may increase the risk for obesity. No health educational resources specifically tailored for them are available. Currently, social networking sites (e.g., Facebook) have become popular among adolescents. Thus, a culturally tailored obesity prevention program for KA adolescents was developed using Facebook (Healthy Teens). The content of the program was developed by an expert panel based on social cognitive theory, and the online program was developed applying web usability principles for adolescents. Objective: To evaluate the usability of a Facebook-based obesity prevention program for KA adolescents. Methods: Initial usability testing was conducted using heuristic evaluation by four experts upon the completion of the development. The Healthy Teens program was revised based on the findings. Then, user testing was conducted using observation, think-aloud method, audiotaping, capturing of screen activity, and surveys. Twenty participants were recruited from two Korean language schools (mean age 15.40±1.50 years). Content analysis using inductive coding approach was performed on the user testing transcriptions by three coders. Descriptive statistics were used to analyze quantitative data (demographics, perceived usability, eHealth literacy, and health behaviors). Results: All participants were Facebook users and had used it for an average of 3.75 years and 1.86 hours daily. Content analysis identified 27 themes under the three categories of content, appearance, and navigation. Participants offered positive comments on content, such as "liked content related to Korean diet." However, they mentioned that some resources and graphics were not age appropriate. Although the Facebook platform provides very limited flexibility in building the site, participants reported that the appearance of the program was appropriate. Most participants did not experience difficulties navigating the program. Perceived usability was 62.25±6.29 (range 10-70). Conclusions: Our preliminary findings indicated that the Healthy Teens program was perceived usable and useful by KA adolescents and can be used as a robust platform to deliver health education to adolescents. Further research is needed to develop optimal usability guidelines that can be applied to develop such programs.
    • The Effect of Resources on Caregiving Experiences in the U.S. Population and among Korean American Caregivers

      Hong, Michin; Harrington, Donna (2011)
      Informal caregivers play a major role in providing long-term care (LTC) for older adults. Given the demands of caregiving, caregivers experience various negative caregiving outcomes and eventually worse health. Despite extensive research, prior research reveals limited knowledge about caregiver health because of a lack of attention toward the role of resources, inconsistent findings, and a dearth of ethnic specific detailed knowledge. Thus, this study aims to examine a health model with two different samples drawn from (1) the 2004 National Long-term Caregiver Survey (NLTCS) and (2) a Korean American (KA) caregiver survey. The health model is built upon the Conservation of Resource (COR) Theory and consists of various sets of variables. Structural equation modeling was used to test the health model in each sample. The measurement models and the initial structural models produced poor model fit; however, after modifications were made the final structural models fit well in each data set. In the NLTCS model, more difficult caregiving condition (i.e., caring for older adults with more health problems and longer caregiving time) was related to having fewer resources (i.e., less feeling of mastery, fewer financial resources, less social support, and less family harmony) and negative primary outcomes (i.e., more stress and burden). Moreover, more resources were related to better primary outcomes and better physical health of caregivers. On the other hand, caregiving condition was not associated with resources in the KA model. However, other paths from caregiving condition to primary outcomes, and from resources (i.e., higher self-efficacy, more financial resources, greater social network, greater family harmony, and higher English proficiency) to primary outcomes and to health were also found in the KA models. The findings indicate that resources are related to primary outcomes as well as the final health outcomes across ethnicities, and the importance of resources may be particularly high among the KA population. This study suggests that caregiver support policies and culturally competent programs be expanded. Further studies using longitudinal data and different indicators of the constructs of interest are needed. Finally, some modifications are suggested for better application of the COR theory to caregiving condition.